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A woman says, 'I can't take anymore! Last year my husband was diagnosed with cancer. Three months ago, I lost my job. Yesterday my daughter said she's quitting college and moving in with her boyfriend.' Which issue should be the focus for crisis intervention?
- A. Possible mastectomy
- B. Disordered family communication
- C. Effects of the divorce
- D. Coping with the reaction to the daughter's events
Correct Answer: D
Rationale: The focus of crisis intervention is on the most recent problem?'the straw that broke the camel's back.' The daughter's decision is the immediate precipitating event causing disequilibrium.
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Which premise is most useful to a nurse planning crisis intervention for any patient?
- A. The patient is experiencing a state of disequilibrium.
- B. The patient is experiencing a type of mental illness.
- C. The patient poses a threat of violence to others.
- D. The patient has a high potential for self-injury.
Correct Answer: A
Rationale: Disequilibrium is universal in crisis, representing a struggle for equilibrium. Other options are not always applicable.
A troubled adolescent opened fire in a high school cafeteria, fatally shooting three people and injuring many others. Hundreds of parents come to the high school after hearing the news reports. After the police arrest the shooter, which action should occur next?
- A. Ask the police to encircle the school campus with yellow tape to prevent parents from entering.
- B. Announce over the loudspeakers, 'The campus is now secure. Please return to your classrooms.'
- C. Require parents to pass through metal detectors and then allow them to look for their children in the school.
- D. Designate zones according to the alphabet, and direct students to the zones based on their surnames to facilitate reuniting them with their parents.
Correct Answer: D
Rationale: Organizing reunification by alphabetized zones is a practical solution to manage chaos and reunite families efficiently.
A patient comes to the clinic with superficial cuts on the left wrist. The patient is pacing and sobbing. After a few minutes with the nurse, the patient is calmer. What should the nurse ask to determine the patient's perception of the precipitating event?
- A. Tell me why you were crying.
- B. How did your wrist get injured?
- C. How can I help you feel more comfortable?
- D. What was happening just before you started feeling this way?
Correct Answer: D
Rationale: A clear definition of the immediate problem provides the best opportunity to find a solution. Asking about recent upsetting events permits the assessment of the precipitating event. Asking 'why' questions are a nontherapeutic communication technique.
At the last contracted visit in the crisis intervention clinic, an adult says, 'I've emerged from this a stronger person. You helped me feel like my life is back in balance.' The nurse responds, 'I think it would be worthwhile to have two more sessions to explore why your reactions were so intense.' Which analysis applies?
- A. The patient is experiencing transference.
- B. The patient demonstrates a need for continuing support.
- C. The nurse is having difficulty terminating the relationship.
- D. The nurse is empathizing with the patient's feelings of dependency.
Correct Answer: C
Rationale: The nurse's suggestion to continue sessions beyond the crisis focus indicates difficulty terminating the relationship.
A patient visiting the crisis clinic for the first time asks, 'How long will I be coming here?' The nurse's reply should consider that the usual duration of crisis intervention is how long in weeks?
- A. 1 to 2
- B. 3 to 4
- C. 4 to 6
- D. 6 to 12
Correct Answer: C
Rationale: The disorganization associated with crisis is so distressing that it usually cannot be tolerated for more than 4 to 6 weeks.